Reports of looting from the devastated homes have led to police adding extra surveillance

Firefighters are escorting earthquake survivors back to their homes — temporarily — to get belongings

The 6.2-magnitude earthquake struck near Norcia in Umbria, central Italy, at 3.30am on Wednesday

In the 2009 earthquake in nearby L'Aquila a survivor was pulled out after 72 hours

250 dead including 8-month-old baby, his brother, nine, and their parents, who were buried in their sleep

Stefano Petrucci, mayor of Accumoli, said some 2,500 people are left homeless in the local community

In the town of Pescara del Tronto, the bodies of the dead were laid out in a children's play park

Are you caught up in the Italian earthquake?

This is the dramatic moment a four-year-old girl was pulled from the rubble alive after her sister, eight, sacrificed her own life by throwing herself on top of her as wreckage from Italy's devastating earthquake encased them.

In one of the most remarkable stories of courage to emerge from the catastrophic 6.2-magnitude quake that struck central Italy on Wednesday, the two girls were found buried together in the rubble of their holiday home in the village of Pescara del Tronto but only one of them survived.

Distraught grandmother Angela Cafini wept as she recalled how her four-year-old grand daughter escaped with barely a scratch thanks to her older sister who lay on top of her to protect her as the house collapsed around them.

'Giulia died saving her sister. She lay on top of her. That is the only reason she is alive. I am told she has no injuries and that is the only explanation for that,' Ms Cafini said.

The village has been virtually wiped from the map with almost every building destroyed.

The astonishing tale of heroism emerged as the death toll from the earthquake rose to 250.

Giorgia, four, was pulled out of the rubble alive with 'no injuries' after her sister saved her life by laying on top of her body

Distraught grandmother Angela Cafini (left) wept as she recalled how her eight-year-old granddaughter sacrificed her life in the earthquake

The eight-year-old girl heroically saved her younger sister from death in the devastated town of Pescara del Tronto (pictured)

'Giulia died saving her sister. She lay on top of her. That is the only reason she is alive,' Mrs Cafini said

As 64-year-old Mrs Cafini spoke she frequently broke down in tears with friends and rescuers coming to comfort her

The two sisters were holidaying in Pescara del Tronto when the catastrophic earthquake struck the town on Wednesday

Pictured is one of the many damaged houses in pictured in Pescara del Tronto which has been virtually wiped off the map

Officials fear the final number of victims will be more than 500 as they continue their painstaking search through the shattered remains of four villages looking for more survivors.

BRITAIN'S FOREIGN SECRETARY BORIS JOHNSON SAYS GOVERNMENT IS HELPING

A number of Britons have been affected by the devastating earthquake in Italy, the Foreign Office said as the death toll continues to rise.

Foreign Secretary Boris Johnson said extra staff had been sent to the region to help provide support to Britons affected by the 'terrible' quake.

The UK Government has offered 'any assistance that we can' to the Italian authorities, Mr Johnson said.

He said: 'My deepest sympathies are with the Italian people and everyone affected by the terrible earthquake that struck central Italy.

'The British Government has offered any assistance that we can to help with the recovery effort and I have spoken with Italian foreign minister Paolo Gentiloni to express my condolences personally.

'As the scale of the disaster has become clearer we now know that a number of British nationals have been affected.

'British Embassy staff are in the region providing consular support, and we have deployed additional staff to support this effort.'

The Foreign Office said it will not be adding anything to this statement at this time after being questioned by the MailOnline over if any Britons have died in Italy.

Mrs Cafini wept as she told Daily Mail Online how one granddaughter died but the other survived. Eight-year-old Giula Renaldo was dead by the time rescuers reached her body while her younger sister Giorgia was alive and is now recovering in hospital.

'They were found together hours after the earthquake hit us,' said Mrs Cafini.

'It is a miracle that she is alive, but I am torn. I have lost one granddaughter and one has lived.'

As 64-year-old Mrs Cafini spoke she frequently broke down in tears with friends and rescuers coming to comfort her. She said her daughter Michaela and son-in-law Fabio were visiting her home in the tiny village perched on a hillside close to the epicentre of the earthquake.

They were on a week's holiday from their home in Rome when the quake struck in the early hours of Tuesday morning. Mrs Cafini was staying at another house previously owned by her own mother and escaped unscathed when the village was wiped out.

Her daughter and son-in-law suffered crush injuries and were taken to hospital in Ascoli Pinceino where they are recovering.

When they were transported from the village they had no idea if their two daughters were alive or dead.

'We had to leave the village because it was so unsafe and they brought us here,' said Mrs Cafini gesturing to a cluster of blue tents erected by the side of the main road leading to Pescara del Tronto.

Bodies of victims lie on the ground in the central Italian village of Amatrice next to devastated locals and rescue workers

Retirees Vittorio and Edde who were at their holiday home in the village of Capo Dacqua were uninjured but said they had lost everything, including the car they had driven from their home in Rome. 'All we have are the clothes that we have on now,' said Vittorio

A wounded man with a bandage on his chin walks along a collapsed road in the town of Amatrice

A police officer (left) weeps after viewing buildings that were damaged during an earthquake, on August 25, 2016 in Amatrice. A woman and child recover on a bench (right) in the same village

An injured man stands with three dogs at the side of the road while a woman (far right) sits wrapped in a sheet

A man with a few belongings walks past destroyed buildings in Pescara del Tronto on Thursday

A rescuer climbs underneath a collapsed building for signs of life following an earthquake in Amatrice

Rescuers in hard hats and mouth masks stand next to ruins in the central destroyed street of Amatrice on Thursday

A fireman stands next to the ruins in the central destroyed street of Amatrice after the death toll rose to 241 on Thursday

A bed and washing machine can be seen inside of a home destroyed during the earthquake in Amatrice

A child holds a stuffed toy as other people sit in a tent set up to house those made homeless following Wednesday's earthquake in Amatrice

'All we could do was sit and wait. It was too dangerous to be in the village. After about 15 hours at 7pm we got word that they had found the girls. One was alive and the other was dead.'

Rescue teams are still searching through the rubble in the village in the faint hope of finding other survivors.

Many of the victims were children, according to Mrs Cafini.

'We have lost so many from the village. There were lots of people, families visiting from Rome. I can't believe what we are going through.'

Meanwhile, rescue workers are reportedly being forced to leave dead bodies inside destroyed homes because they are running out of body bags.

An ambulance worker who found a woman crushed in her bed in Sant'Angelo told The Mirror: 'She's dead but there are no more body bags so we just have to wait.'

Their are also reports of looting from some of the shattered homes, leading to police bringing in extra security.

In a makeshift tent city just outside Pescara Del Tronto, retirees Vittorio and Edde who were at their holiday home in the village of Capo Dacqua said they were uninjured but had lost everything, including the car they had driven from their home in Rome.

'All we have are the clothes that we have on now,' said Vittorio.

'We were lucky. Our house was not badly damaged and we stayed inside an hour before the firemen came and got a ladder to get us down from the balcony.

'We want to go back to Rome but are worried about our possessions in the house.'

A survivor of the earthquake is transported on a stretched after being pulled out from rubble on Thursday

Emergency workers remove a body from a building that was destroyed during in Amatrice

A survivor embraces a rescuer in Amatrice on Thursday as the search and rescue mission continued

An exhausted rescue worker carries a small dog in her arms in Amatrice. More than 4,300 people are involved in the search

As dawn broke on Thursday, rescue workers in Amatrice continued to search for survivors of the central Italian earthquake

The remnants of what was once a home - including a wardrobe and window frames - can be seen in this demolished house in Amatrice

Rescuers scale the roof of a destroyed home on Thursday in Pescara Del Tronto, central Italy, as the hunt continues for survivors and bodies

This car in Amatrice was completely crushed by falling rubble but thankfully no passengers were inside it at the time

Weeping in a campsite erected to house the homeless from a string of mountain villages, Rita Rosine, 63, said her 75-year-old sister was trapped under the ruins of a collapsed house, presumed dead.

'The situation is worse than in war. It's awful, awful ... they say it will take two days to dig her out because they have to shore up the surrounding buildings.

'She didn't deserve to die like that, she was so good.'

The Red Cross is shipping in food and water supplies for homeless residents. Among those who came to pick up emergency provisions were Maria Atrimala, 48, and her 15-year-old daughter.

'We escaped by pure luck, the stairs of the house held and we ran, blindly in the dark and dust,' she said with tears rolling down her face.

'When we got out we could hear the cries of people still trapped and we helped those we could.

'We were in L'Aquila when the earthquake struck there, and now this. We have friends, relatives that didn't make it. What the future holds I don't know.'

Mario, a father of two small boys, said he was still in shock. 'We slept in the car last night, though with the quakes it was hard to sleep at all,' he told AFP between sips of Coke.

'We've booked a tent for tonight. But then tomorrow, the next day?'

Italian firefighters are escorting earthquake survivors back to their homes — temporarily — to get some belongings left behind when they fled the shaking.

In Amatrice, many elderly and children spent the night inside a local sports facility.

On Thursday dramatic footage of a ten-year-old girl being pulled alive from the village emerged as rescuers toiled through the night in the search for survivors.

The girl, who has not been named, was found after almost 17 hours.

As rescue efforts continue officials said more than 4,300 people are involved in what is now effectively become a search and recovery operation.

Specialist teams, including those expert in mountain and cave rescues, were heavily involved in the searches in the four mountainside towns and villages of Amatrice, Accumoli, Arquata del Tronto and Pescara del Tronto.

Sniffer dogs, firefighters and rescue crews had worked through the night using their bare hands to pull chunks of cement, rock and metal apart from mounds of rubble where homes once stood searching for signs of life.

'Unfortunately, 90 percent we pull out are dead, but some make it, that's why we are here,' said Christian Bianchetti, a volunteer from Rieti who was working in devastated Amatrice.

Earthquake survivors share food as they emerge from makeshift shelters and tents in a temporary encampment on open ground in the central Italian village of Amatrice

A dog that survived the earthquake stands on a bridge in the park where local residents camped out overnight

In the town of Amatrice survivors were put up overnight in a sports hall as aftershocks continued to cause terror

Earthquake survivors created makeshift homes outside after their homes were destroyed and friends and family were killed in Amatrice

Rescue workers grab some food at the tent camp refectory in Arquata del Tronto, Italy. Food has been donated by the Red Cross

Survivors of the quake were forced to sleep in a tent camp near Pescara Del Tronto, Italy, after their entire town was almost completely flattened

Hundreds of people spent the night sleeping in their cars or in hastily-assembled tents, the aftershocks adding to their discomfort. These tents are set up in Arquata del Tronto

The Red Cross began shipping in food and water supplies for homeless residents. Among those who came to pick up emergency provisions were Maria Atrimala, 48, and her 15-year-old daughter. 'We escaped by pure luck,' she said

Shocked and scared people drink water in a tent camp near Pescara Del Tronto on Thursday morning as aftershocks continued to be felt in the area

A building severely damaged after being struck by the earthquake in Amatrice hangs on precariously as the sunrises on Thursday morning

DAY TWO OF THE FRANTIC SEARCH OPERATION

The Red Cross has appealed for people in the area to disable their wifi passwords so rescuers can communicate with each other more easily.

Reports of looting inside the devastated homes have emerged and police are now enforcing surveillance.

Three bodies have been pulled from the ruins of an institute of nuns in Amatrice. On Wednesday, two nuns trapped in the debris at the convent and church of the Most Holy Crucifix were rescued by a pair of local forest rangers.

Rescue workers say 35 people were trapped in the Hotel Roma in Amatrice. Most guests managed to escape but 10 are still missing and five bodies were pulled from the rubble.

Fernando Scasciafratti, an official of Rieti province, has described how he pulled a distraught Peruvian boy from the rubble and covered him with abandoned Italian flags to keep him warm. 'I gave him a kiss on the cheek and told him 'it's over',' he said La Repubblica reported.

One area of focus was the Hotel Roma in Amatrice, famous for the Amatriciana bacon and tomato pasta sauce that brings food lovers to this medieval hilltop town each August for its food festival.

Amatrice's mayor had initially said 70 guests were in the crumbled hotel ahead of this weekend's festival, but rescue workers later halved that estimate after the owner said most guests managed to escape.

Firefighters' spokesman Luca Cari said that one body had been pulled out of the hotel rubble just before dawn but that the search continued there and elsewhere, even as aftershocks rattled the area.

'We're still in a phase that allows us to hope we'll find people alive,' Cari said, noting that in the 2009 earthquake in nearby L'Aquila a survivor was pulled out after 72 hours.

Worst affected by the quake were the tiny towns of Amatrice and Accumoli near Rieti, 100 kilometers (60 miles) northeast of Rome, and Pescara del Tronto, 25 kilometers (15 miles) further east.

Italy's civil protection agency reported the death toll had risen to 241 early Thursday with at least 368 others injured. Most of the dead - 190 - were in Amatrice and Accumuli and their nearby hamlets.

The 73rd Venice Film Festival, which starts next week, has cancelled its opening night festivities to honour the dead.

Festival director Alberto Barbera tweeted today: 'Gala dinner and cocktail party on the beach cancelled for the opening of #Venice73 in respect and solidarity to the victims of the earthquake.'

As the search effort continued, the soul-searching began once again as Italy confronted the effects of having the highest seismic hazard in Western Europe, some of it in its most picturesque medieval villages, and anti-seismic building codes that aren't applied to old buildings and often aren't respected when new ones are built.

'In a country where in the past 40 years there have been at least eight devastating earthquakes ... the only lesson we have learned is to save lives after the fact,' columnist Sergio Rizzo wrote in Thursday's Corriere della Sera. 'We are far behind in the other lessons.'

Experts estimate that 70 percent of Italy's buildings aren't built to anti-seismic standards. After every major quake, proposals are made to improve, but they often languish in Italy's thick bureaucracy, funding shortages and the huge scope of trying to secure thousands of ancient towns and newer structures built before codes were passed or after the codes were in effect but in violation of them.

In recent quakes, some of these more modern buildings have been the deadliest: the university dormitory that collapsed in the 2009 L'Aquila quake, killing 11 students; the elementary school that crumbled in San Giuliano di Puglia in 2002, killing 26 children - the town's entire first-grade class. In some cases, the anti-seismic building standards have been part of the problem, including using reinforced cement for roofs that are then too heavy for weak walls when quakes strike.

In Amatrice, many elderly and children spent the night inside a local sports facility with donated blankets and pillows

People talk at a makeshift camp in Arquata. The civil protection agency set up tent cities around the affected towns to accommodate the homeless

A car is found crushed and covered in rubble on Thursday morning as the toll of the Italian earthquake in the town of Amatrice begins to sink in

One of many exhausted firefighters talks on his phone next to the rubble of a building that collapsed in Amatrice

Rescuers clear debris while searching for victims in damaged buildings in the mountainside village of Arquata del Tronto

A crumbled road in Amatrice is pictured (left) alongside a search dog handler (right) who is tirelessly searching for survivors

Premier Matteo Renzi, visiting the quake-affected zone Wednesday, promised to rebuild 'and guarantee a reconstruction that will allow residents to live in these communities, to relaunch these beautiful towns that have a wonderful past that will never end.'

While the government is already looking ahead to reconstruction, rescue workers on the ground still had days and weeks of work ahead of them. In hard-hit Pescara del Tronto, firefighter Franco Mantovan said early Thursday that crews knew of three residents still under the rubble, but in a hard-to-reach area.

One man, Guido Bordo, 69, lost his sister and her husband after they were trapped inside their holiday house in the hamlet of Illica, north of hard-hit Amatrice. Before their deaths were confirmed, he had described how he could only hear the sound of cats as he scrambled to find his loved-ones beneath the rubble.

The first victim to be named by local media reports was Marisol Piermarini - an 18-month-old baby who was sleeping in her crib when the house she was staying in Arquata del Tronto collapsed. Mother Martina and father Massimiliano have been taken to hospital with 'many wounds' after being pulled from the rubble.

Tragically, the family had moved to the area from L'Aquila after their home there was destroyed in another earthquake in 2009.

The little girl's grandfather, Massimo Piermarini, said he desperately tried to save his family: 'They did not want me to go in because it was all in danger, but I said that I did not care at all, I had to go looking for them, but unfortunately for the girl there was nothing to do.'

Some of the worst damage was suffered in Pescara del Tronto, a hamlet near Arquata in the Marche region where the bodies of the dead were laid out in a children's play park.

Rescuers carry a man on a stretcher among damaged buildings after a strong earthquake hit central Italy, in Arquata del Tronto

Hundreds of people spent a chilly night wrapped in blankets or in hastily-assembled tents with the risk of aftershocks making it too risky for them to return home

Rescuers search through debris following an earthquake in Pescara Del Tronto. The magnitude 6 quake struck at 3.36am

Recovered bodies lay covered on the ground in a child's play area in the town of Pescara del Tronto

The rescue mission was continuing in Pescara Del Tronto, one of the areas devastated by the Italian earthquake

Covered: In what looks like an image from Pompeii, the town of Amatrice is seen smothered in grey dust and rubble in this aerial photo

Dante's Inferno: Agostino Severo, a Rome resident on holiday, described Amatrice as looking like 'Dante's Inferno'. 'People crying for help, help. Rescue workers arrived after one hour... one and a half hours,' he said

The 6.2-magnitude quake struck at 3.30am local time this morning while villagers slept in their beds. Rescuers are pictured walking through the rubble in Amatrice

Catastrophic: Only a few buildings appeared to still be in tact amidst the absolute devastation in the town of Amatrice

Collapse: The Mayor of Amatrice described how 'the roads in and out of town are cut off. Half the town is gone - there are many dead'

Still standing: This red brick building is one of the only remaining structures in the historical part of the town of Amatrice

Strong tremors were felt in the capital Rome, more than 100 miles from the epicenter near the city of Perugia - the epicentre was between Norcia and Accumoli

Heartbreaking: The body of an unidentified child lies on a bench covered in a pink sheet in Arquata del Tronto, Italy

Victims: The bodies of three people tragically killed in the earthquake in Pescara del Tronto lie in body bags in front of rescuers

Distraught: Rescuers help a woman among dressed only in a sheet after she was saved from damaged buildings in Amatrice

Escape: An injured man covered in dust is carried out of a crumbling building on a stretcher by a team of rescue workers in Amatrice

Agony: A man is pulled out of the rubble with a large gash in his head following the earthquake in Amatrice

Saved: A man cries (left) as the injured local is delicately pulled from the rubble while another rescuer prevents bricks from sliding down on top of him

Ripped open: The bedroom interior of one resident's home in Pescara del Tronto is about the only thing that remains intact

In ruins: Barely any buildings remain intact in the town of Pescara del Tronto after the devastating earthquake

Hope: Dramatic footage showed the moment a woman was discovered trapped alive under the rubble in the town of Accumoli in Italy

Pulled out: A team of rescue workers help gently lift a man from a devastated building in Amatrice

Survivor: A dust-covered man trapped in the rubble of his home as he slept is pulled from a hole by rescuers in Amatrice this morning

Help: A team of rescue workers and local men carry a body on a stretcher out of the rubble in the central Italian town of Amatrice

Bloodied: An injured nun checks her mobile phone as she lies near a ladder and a blanket following an earthquake in Amatrice

Crying out: A woman stands among damaged buildings and screams in attempt for to find loved ones trapped in Amatrice

Side by side: The historical center of the town of Amatrice was completely wiped out but the newer part of town appears to remain standing

EUROPE'S DEADLIEST EARTHQUAKES AND WHY ITALY IS TORMENTED BY QUAKES

The earthquake in Norcia occurred in a shallow fault in the Apennines, a chain of mountains that form the backbone of Italy's 'boot'. It is well known for being a highly complex and geologically active region as it sits at a point where several tectonic plates grind against each other.

According to the US Geological Survey, this morning's earthquake occurred at a depth of 6.2 miles (10km) on a fault that runs from the northwest to the south east. The epicentre was in the mountains just 6.2 miles to the southeast of Norcia.

It was caused by the stretching of the Earth's crust as the tectonic plates beneath moved apart. Since the late Miocene a large basin has been opening up under the western Mediterranean Sea at the point where the massive Eurasian tectonic plate meets the African plate.

Here the African plate is driven under the Eurasian plate in a process known as subduction. However, due to the forces involved, the bend in the African plate as it is forced beneath its neighbour can occasionally move backwards in a process known as 'roll back'.

This map shows how fault lines run right up the spine of Italy and where the epicentre of Wednesday's earthquake was located

This map shows the location of the quake's epicentre and where activity has been measured

It is similar to the effect seen when bending a piece of paper towards one end and then moving your hands – this will cause the bend to roll from one side to the other. When this happens in the tectonic plates, however, the Eurasian plate remains stuck to the African plate and stretches in a process known as 'back-arc spreading'. This is creating a region known as the Tyrrhenian basin under the sea between mainland Italy and Sardinia.

The earthquake in Norcia is thought to have been caused by the opening of the Tyrrhenian basin occurring faster than the compression between the Eurasian and African plates, causing the earth's crust to stretch.

At the location of the earthquake, the Eurasian plate moves towards the northeast with respect to the African plate at a rate of around 24mm/yr, according to the US Geological Survey.

A build up in pressure at this junction was suddenly released this morning, creating the magnitude 6.2 earthquake.

Compared to other much larger earthquakes, such as the one off the coast of Japan in 2011 which was magnitude 9.0, it occurred at a much shallower depth.

The 2011 Japanese earthquake was more than 18.6 miles down while the one under the Apennines was just a third of that.

The shallow depth of the earthquake may account for the high levels of destruction seen in Norcia.

Unimaginable: An elderly man in a tracksuit walks on the rubble of a collapsed buildings in Amatrice. A television aerial can be seen alongside the bricks

In 2016 a 7.0 earthquake at a depth of 6.2 miles (10km) in Kumamoto City in Japan killed 49 people, injured 3,000 and left much of the city in ruins.

There have been several earthquakes under the central Apennine region in recent years.

In September 1997 there was a magnitude 6.0 earthquake 31 miles (50km) northwest of Norcia.

On that occasion 11 people were killed and 100 injured. Around 80,000 homes were destroyed in the Marche and Umbria regions.

In April 2009 a magnitude 6.3 earthquake occurred 28 miles (45km) to the south east of Norcia near the town of L'Aquila.

That killed at least 295 people and injured 1,000 while 55,000 people were left homeless.

Huge landslides occurred in the region and at least five aftershocks bigger than magnitude 5.0 rocked the area.

The largest recorded earthquake in the region, however, occurred 42 miles (68km) to the southwest near Avezzano in January 1915, when the area was rocked by a magnitude 6.7 shake.

Europe is no stranger to deadly earthquakes. Here we list the most devastating:

28 December 1908 –Sicily and southern Italy. This magnitude 7.1 earthquake almost completely destroyed the Sicilian port city of Messina and Reggio Calabria in southern Italy. Between 75,000 and 200,000 people were killed although some estimates put the deathtoll at 95,000.

11 January 1693 – Sicily. The most powerful earthquake in Italian history, this magnitude 7.4 quake destroyed at last 70 towns and cities. It caused the death of around 60,000 people.

1 November 1755 – Lisbon, Portugal. Known as the Great Lisbon earthquake, it struck on the holiday day of All Saint's Day at around 9.40am, sparking fires and a tsunami. Geologists have estimated it had a magnitude of between 8.5 and 9. Lisbon was almost totally destroyed and it is thought that a fifth of the city's population perished. A further 10,000 are thought to have died in Morocco, bringing the deathtoll to an estimated 50,000.

26 December 1939 – Erzincan, Turkey. With a recorded magnitude of 7.8, this quake caused extensive damage around Erzincan and along the Kelkit River. Around 32,700 people died.

13 January 1915 – Abruzzi, central Italy. This magnitude 6.7 earthquake destroyed the town of Avezzano which sat directly over the epicentre. It left 32,000 people dead and caused $60 million of damage.

17 August 1999 – Turkey. More than 17,000 people were killed and 50,000 injured in this magnitude 7.6 earthquake. Nearly 37 seconds of strong shaking caused widespread damage in Istanbul, Izmit, Kocaeli and Sakarya.

3 October 1914 – Burdur, Turkey. More than 17,000 houses were destroyed in this magnitude 7.0 earthquake and around 4,000 people lost their lives.

26 November 1943 – Ladik, Turkey. A magnitude 7.6 earthquake that caused the deaths of around 4,000 people and destroyed three quarters of the homes in the Ladik-Vezirkopru area.

1 February 1944 – Gerede, Turkey. About 50,000 homes were destroyed in this magnitude 6.5 earthquake and 2,790 people perished.

23 November 1980 – Campania and Basilicata, southern Italy. A magnitude 6.5 earthquake that claimed the lives of 2,735 people and left 394,000 people homeless.

Agostino Severo, a Rome resident visiting Illica, said: 'We came out to the piazza, and it looked like Dante's Inferno. People crying for help, help. Rescue workers arrived after one hour... one and a half hours.'

On Wednesday the Queen joined others from around the world in sending a message of condolence to Italy, saying she was saddened to hear of the loss of life and that her thoughts were with families affected. President Barack Obama called Italian President Sergio Mattarella and saluted the 'quick action' by first responders in Italy.

The quake's epicentre was near Norcia in Umbria, about 105 miles north east of Rome, and falling bridges and landslides meant some areas are still cut off with emergency teams only able to get there on foot.

The mayor of Accumoli, Stefano Petrucci, said this morning: 'My town isn't here anymore' as people were carried out of ruined buildings on stretchers and people desperately searched the debris for survivors or sobbed as they inspected their own ruined homes.

Photographer Emiliano Grillotti said that in Accumoli he saw over 15 people digging with their bare hands to save a family of four with two children. He said: 'I can hear one of the children screaming'.

The frantic search for survivors was continuing into the night after the death toll increased to 241 in the wake of the Italian earthquake disaster. Rescuers are pictured working through the rubble in Pescara Del Tronto

As the light started to fade in Amatrice, rescue workers stepped up their search operation under floodlights

Volunteers assist rescue emergency service personnel in front of a damaged house in the central Italian village of Amatrice

Rescuers scaled a roof in Amatrice as they continued their hunt for survivors

A woman was given emergency treatment as medics moved her to a waiting ambulance in Amatrice

Rescuers are pictured lifting a man out of the ruins of a building destroyed during the earthquake in Amatrice

Disaster zone: Pictures show the extent of the devastation caused by the 6.2-magnitude earthquake in Pescara del Tronto

Some of the worst damage was suffered in Pescara del Tronto, a hamlet near Arquata in the Marche region where the bodies of the dead were laid out in a children's play park

Aftermath: Dozens of rescuers have been called in to search through debris following the earthquake in Italy

A picture of the Virgin Mary and Baby Jesus lies on the debris of a collapsed house in Amatrice following the earthquake

A firefighter takes a rest in the central Italian village of Amatrice. A huge rescue mission is expected to continue into the night

A man walks through the rubble in the devastated town of Amatrice. Wednesday's disaster is the biggest in the region since April 2009

A body is carried away on a stretcher as rescuers continue the hunt for survivors of the deadly earthquake

Wednesday's disaster is the biggest in the region since April 2009 when a 6.3 magnitude earthquake occurred 28 miles to the south east of Norcia near the town of L'Aquila, killing 295 people and injuring 1,000. That disaster led to lengthy recriminations over lax building controls and the failure of authorities to warn residents that a quake could be imminent.

The first victims of the devastating quake were an elderly couple whose home collapsed in Pescara del Tronto, in the Marche region, around ten miles from the epicentre. A family of four, including a eight-month-old baby and his brother, nine, were also reported dead in the town of Accumoli.

As rescue workers carried away the body of the infant, carefully covered by a small blanket, the children's grandmother blamed God: 'He took them all at once,' she wailed.

Volunteers had to light up the collapsed buildings as they continued a desperate search for survivors in the town of Pescara Del Tronto

Rescuers showed no sign of slowing up as the light started to fade in Amtrice this evening

Dozens of fire fighters were called in to help in the rescue effort and were on hand to lift bodies from the rubble

A volunteer grimaces as he carries a sledge hammer up a mound of rubble as the search operation continued

Rescuers kept to the grim task of lifting bodies from the scene of the disaster this afternoon

People carry bottles of water as they organise a help area in the central Italian village of Amatrice

SHARE PICTURE

Rescuers recover a dog from a collapsed house after an earthquake hit Pescara del Tronto

A woman walks past rubble following an earthquake in Amatrice. Hundreds of volunteer rescuers have joined the hunt for survivors

Their homes left in ruins, some residents in Amatrice set up camp on the street as the rescue operation continued

A Mickey Mouse doll lies amidst the debris of a collapsed house following the earthquake in Amatrice

Two brothers, aged four and seven, were pulled from the rubble nearby after hiding under a bed with their grandmother as the building fell down. Some 100 people were still unaccounted for in the village of Arquata del Tronto.

A newborn baby was also found dead after being pulled from a family home in the center of Arquata del Tronto.

The quake hit during the summer when the populations of the towns and villages in the area, normally low during the rest of the year, are swelled by holidaymakers.

Accumoli mayor Stefano Petrucci said on Wednesday: 'Now that daylight has come, we see that the situation is even more dreadful than we feared, with buildings collapsed, people trapped under the rubble and no sound of life.

'We have a tragedy here. Four people are under the rubble, but they are not showing any sign of life. Two parents and two children.

Hard to help: Because of the mountainous location of the villages hit by the earthquake many of the roads are inaccessible and helicopters are being used to rescue locals from towns such as Pescara del Tronto (pictured)

Winched to safety: An injured person is rescued via helicopter following the earthquake in Pescara del Tronto on Wednesday

Wiped out: An aerial view of Pescara del Tronto shows how the strength of the earthquake flattened towns

'It is a disaster, we have no light, no telephones, the rescue services have not got here yet.'

The quake also destroyed homes and buried people under rubble in the small town of Amatrice, where many more are feared dead.

'The roads in and out of town are cut off. Half the town is gone,' said the town's mayor Sergio Pirozzi.

He added: 'There are people under the rubble... There's been a landslide and a bridge might collapse. The situation is dramatic, there are many dead. I cannot give a toll for now because rescue efforts are under way and it is very, very difficult'.

The centre of Amatrice was devastated, with entire palazzos razed to the ground. Rocks and metal tumbled on to the streets and dazed residents huddled in piazzas as aftershocks continued into the early hours.

'The whole ceiling fell but did not hit me,' marveled resident Maria Gianni. 'I just managed to put a pillow on my head and I wasn't hit luckily, just slightly injured my leg.'

Another resident said she had been woken by the shaking in time to witness the wall of her bedroom cracking open. She was able to escape into the street with her children.